Get a quick look at October’s Medicaid news in the Syrtis Solutions monthly recap. Browse key developments in legislation, cost avoidance, and payment oversight, including efforts to prevent improper payments and address fraud, waste, and abuse. Click and read the news....
Cost avoidance helps Medicaid health plans address a persistent financial problem: paying claims before determining whether another insurer should be responsible. With healthcare expenditures increasing and state budgets under pressure, accurate insurance identification has become an important part of managing costs and improving payment integrity....
Syrtis Solutions provides a monthly Medicaid news summary to keep healthcare leaders informed of important industry developments. Each edition covers research, legislation, and policy updates related to Medicaid program integrity, cost avoidance, coordination of benefits, improper payments, and fraud, waste, and abuse. Below is a...
Cost avoidance is gaining importance as Medicaid health plans face growing pressure to find savings and make the most of limited program dollars. With budgets tightening and federal oversight evolving, plans are looking for financial opportunities that do not require benefit reductions, reimbursement changes, or...
Syrtis Solutions delivers a monthly Medicaid news summary focused on issues that matter to Medicaid programs and health plans. The roundup covers developments in program integrity, cost avoidance, coordination of benefits, improper payments, fraud, waste, and abuse, along with relevant research and legislation. Below is...
Medicaid payment integrity depends on accurate, timely information being available when claims are processed. An August 2026 HHS OIG audit found continued shortcomings in federal payment integrity efforts and reported an increase in Medicaid's improper payment rate for FY2025. The HHS OIG report found Medicaid's improper...
Syrtis Solutions monitors Medicaid news and developments throughout the month to provide healthcare leaders with a concise monthly recap. Coverage includes program integrity, cost avoidance, coordination of benefits, improper payments, fraud, waste, and abuse, as well as relevant research and legislative updates. Below are highlights...
Payment Prevention is increasingly shaping the future of Medicaid program integrity. While fraud detection and post-payment recovery remain critical, federal policy is placing greater emphasis on preventing erroneous payments before they occur. The March 2026 launch of the federal Task Force to Eliminate Fraud and...
Syrtis Solutions provides a monthly update on Medicaid news to help healthcare leaders monitor the evolving policy and regulatory environment. The summary highlights developments related to program integrity, coordination of benefits, cost avoidance, and the prevention of improper payments, fraud, waste, and abuse. Below is...
Automated algorithmic analysis and insurance discovery engines (AAAIDE) are becoming cornerstones of modern Medicaid operations. By identifying liable third-party coverage at the point of claim adjudication, these technologies reduce improper payments, strengthen payment accuracy, and improve coordination of benefits. This priority is now reflected in state...